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January 1, 2008International Heart JournalOpen Access

An Experimental Study on the Site Dependency and Mechanism of Vagal Denervation Following Radiofrequency Catheter Ablation for Supraventricular Arrhythmias Including Atrial Fibrillation

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Population

28 mongrel dogs weighing 12 to 15 kg

Comparison

Radiofrequency catheter ablation at the ostium… vs Comparison between different RFCA sites and…

Design

Preclinical

Follow-up

10 minutes after RFCA

Key result

Right pulmonary vein radiofrequency catheter ablation markedly damaged vagal innervation of the sinoatrial node (%DPPI 33.5%), whereas left pulmonary vein ablation produced no significant damage (%DPPI 101.6%).

Authors

SKShinsuke KamedaYKYuichiro KawamuraYIYasuhito Iida

Discussion

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Overview

Does not support changes in ablation site selection; leaves open translation of site-dependent vagal effects to human AF outcomes.

Structured PICO

P
Population
28 mongrel dogs weighing 12 to 15 kg undergoing experimental radiofrequency catheter ablation to assess vagal denervation.
I
Intervention
Radiofrequency catheter ablation (RFCA) at the ostium of the right pulmonary vein (RPV), left pulmonary vein (LPV), or posteroseptal site of the right atrium (PS)
C
Comparator
Comparison between different RFCA sites (RPV, LPV, PS) and baseline measurements before RFCA
O
Outcome
Degree of vagal denervation assessed by the percent ratio of the P-P interval (%DPPI) after electrical stimulationsurrogate

Main Result

Absolute Event Rate: 33.5% vs 101.6%

p-value: p=<0.01

Right pulmonary vein RFCA causes significant partial postganglionic vagal denervation of the sinoatrial node, whereas left pulmonary vein RFCA has little effect, suggesting site-dependent autonomic impacts of AF ablation.

Limitations

  • Animal model (canine) may have discrepancies with human cardiac parasympathetic distribution.
  • Difficult to prove the lack of preganglionic fiber damage in the experimental model.
  • The exact neural distribution in both atria remains unclear and requires further investigation.
  • Difficult to prove the lack of preganglionic fiber damage in the model
  • Exact neural distribution in both atria remains unclear

Cite This Study

Kameda et al. (2008) studied Supraventricular arrhythmias (experimental model) (n=28). Radiofrequency catheter ablation (RFCA) vs. Different ablation sites (Right pulmonary vein vs Left pulmonary vein vs Posteroseptal site) was evaluated on Percent ratio of the P-P interval (%DPPI) after electrical stimulation of the cervical vagal trunk (p=<0.01). Right pulmonary vein radiofrequency catheter ablation markedly damaged vagal innervation of the sinoatrial node (%DPPI 33.5%), whereas left pulmonary vein ablation produced no significant damage (%DPPI 101.6%).

synapsesocial.com/papers/6a22aee8a1bd7ea8dd11b475https://doi.org/10.1536/ihj.49.493
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